PURPOSE OF REVIEW: We review the results from relevant clinical trials and discuss current strategies in the melanoma adjuvant setting. RECENT FINDINGS: The favorable therapeutic efficacy and the significant less toxicity of nivolumab compared with ipilimumab, fully substitutes today's approval of ipilimumab, regardless mutation status, whereas in BRAF-mutated patients, dabrafenib and trametinib seem to confirm their high efficacy also in adjuvant setting. The use of interferon is restricted to patients with ulcerated melanoma and countries with no access to the new drugs. SUMMARY: Systemic adjuvant treatment after complete disease resection in high-risk melanoma patients aims to increase relapse-free survival (RFS) and overall survival (OS). According to the eighth edition of melanoma classification of American Joint Committee on Cancer (AJCC), the prognosis in stage III patients is heterogeneous and depends not only on N (nodal) but also on T (tumor thickness) category criteria. Recent data from randomized, phase-3 clinical trials analyzing the use of adjuvant anti-programmed death-1 and targeted therapies ultimately affect the standard of care and change the landscape of the adjuvant treatment.
PURPOSE OF REVIEW: We review the results from relevant clinical trials and discuss current strategies in the melanoma adjuvant setting. RECENT FINDINGS: The favorable therapeutic efficacy and the significant less toxicity of nivolumab compared with ipilimumab, fully substitutes today's approval of ipilimumab, regardless mutation status, whereas in BRAF-mutated patients, dabrafenib and trametinib seem to confirm their high efficacy also in adjuvant setting. The use of interferon is restricted to patients with ulcerated melanoma and countries with no access to the new drugs. SUMMARY: Systemic adjuvant treatment after complete disease resection in high-risk melanomapatients aims to increase relapse-free survival (RFS) and overall survival (OS). According to the eighth edition of melanoma classification of American Joint Committee on Cancer (AJCC), the prognosis in stage III patients is heterogeneous and depends not only on N (nodal) but also on T (tumor thickness) category criteria. Recent data from randomized, phase-3 clinical trials analyzing the use of adjuvant anti-programmed death-1 and targeted therapies ultimately affect the standard of care and change the landscape of the adjuvant treatment.
Authors: Peter Mohr; Felix Kiecker; Virtudes Soriano; Olivier Dereure; Karmele Mujika; Philippe Saiag; Jochen Utikal; Rama Koneru; Caroline Robert; Florencia Cuadros; Matias Chacón; Rodrigo U Villarroel; Yana G Najjar; Lisa Kottschade; Eva M Couselo; Roy Koruth; Annie Guérin; Rebecca Burne; Raluca Ionescu-Ittu; Maurice Perrinjaquet; Jonathan S Zager Journal: Melanoma Manag Date: 2019-10-04
Authors: Mark Kriegsmann; Katharina Kriegsmann; Alexander Harms; Rémi Longuespée; Christiane Zgorzelski; Jonas Leichsenring; Thomas Muley; Hauke Winter; Daniel Kazdal; Benjamin Goeppert; Arne Warth Journal: Diagn Pathol Date: 2018-09-11 Impact factor: 2.644